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Published on Leave a comment on Autism Spectrum Disorder Rates Hit New High
Child Credit: Wikipedia

The CDC reports that autism (autism spectrum disorder) rates are still increasing in the US, from 1 in 150 twenty years ago to 1 in 36 children in 2020. That's huge!

It's not just better screening and diagnosis. Rates are increasing so rapidly that researchers agree that there are environmental factors going on. But what are they?

The researchers of the report point out known factors (e.g., age of parents, multiple gestation birth, prematurity, genetics), but what is not discussed are all the chemical toxins in our environment that people are exposed to both prenatally and after birth (postnatally). Studies find that pregnant women are exposed to more harmful industrial chemicals nowadays than ever before.

For example, lead, heavy metals, and pesticides. People use pesticides in the home, on home exteriors, in their gardens and lawns, on pets, on crops, they're in foods we eat, in water we drink, even in rainfall (!). Millions of pounds are used each year in the US. Many of them have neurological effects.

This means that babies and young children are also exposed to more pesticides than ever before. The American Academy of Pediatrics has been warning about the dangers of pesticide exposure in children for years.

Excerpts from Futurity (site for research news from universities): United States autism rates hit new high

More children have been diagnosed with autism than at any time since monitoring began more than two decades ago, according to new federal studies. About 4% of 8-year-old boys and 1% of 8-year-old girls, in the United States have autism, according to the US Centers for Disease Control and Prevention (CDC). ...continue reading "Autism Spectrum Disorder Rates Hit New High"

Published on Leave a comment on Vitamin D and Folic Acid Levels During Pregnancy

 Two interesting studies about vitamins during pregnancy and possible effects on the child. One found that low levels of vitamin D3 is linked to behavioral issues and ADHD symptoms in preschool aged children, while the other raises the possibility of very high levels of folic acid during pregnancy linked to autism in the child. More studies are needed.

From Medscape:  Maternal Vitamin D Deficiency and Behavioral Issues in Offspring

Maternal vitamin D deficiency in early pregnancy is associated with an increased risk of behavioral issues and attention-deficit/hyperactivity disorder (ADHD)–like symptoms in preschool children, according to new data from a birth cohort study in Greece. But no association was found between maternal vitamin D deficiency and cognitive scores in the children at age 4, reported Vasiliki Daraki, MD, an endocrinologist from the University of Crete, Heraklion, Greece, who led the analysis, which was  a poster presented at the European Congress of Endocrinology 2016.

The analysis showed that maternal vitamin D levels lower than 50 nmol/L during the first trimester of pregnancy were associated with increased behavioral problems and ADHD-like symptoms among the offspring...."The lower the mother's vitamin D levels, the higher the child's hyperactivity and inattention," reported Dr Daraki.

"I think the role of vitamin D in the developing brain is in neuronal differentiation and axon development, and these are more important for behavioral problems than for cognition," Dr Daraki added.....In the future, she and her colleagues intend to measure the cognitive function and behavioral status at the age of 7 years and determine whether the results still hold at the later age.

From Medical Xpress:  A study asks: Too much folic acid a cause of autism?

For decades, pregnant women and women who may become pregnant have been advised to take folic acid to help prevent certain birth defects. But a new study suggests it may be possible to get too much of a good thing—very high levels of the vitamin in mothers' blood at the time of childbirth was linked to higher risk of their children developing autism years later. (Other research points to an opposite relationship between folic acid and autism, showing that adequate amounts of the vitamin at the time of conception can significantly reduce the risk.) 

Folate is a vitamin found in foods that is important in cell growth and development of the nervous system. A synthetic version, folic acid, is used in supplements and is used to fortify flour and cereals. Decades ago, researchers found certain levels of folic acid could prevent major birth defects of the baby's brain and spine. In the early 1990s, U.S. health officials began recommending that all women who might become pregnant should take 400 micrograms of folic acid daily. And in the late 1990s, federal regulations began mandating that folic acid be added to flour, bread and other grain products.

The new researchers followed 1,391 children who were born at Boston University Medical Center in 1998 through 2013. About 100 of them were later diagnosed with an autism spectrum disorder. The researchers went back and looked at levels of folate and vitamin B12 in the blood of the children's mothers at the time of childbirth. They found that 16 of them had very high levels of folate, and 15 had extremely high levels of vitamin B12. If both levels are extremely high, there is more than a 17-fold greater risk that a child will develop autism, the researchers said. 

Most of the moms in the study said they took multivitamins—which would include folic acid and vitamin B12—throughout their pregnancy. But the researchers say they don't know why some women had such high levels in their blood. It may be related to taking too many supplements and eating too many fortified foods. Or there could be a genetic reason that caused some women to absorb more folate than others. Or there could be a combination, they said.

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A study by researchers showing troubling effects from certain pesticides (especially a class of fungicides) raises all sorts of questions: What is the long-term effect of chronic low doses of these fungicides in the foods we eat? How much of these chemicals are we getting exposed to? The Univ. of North Carolina researchers studied the effect of 294 chemicals (all common food-use pesticides or other environmental chemicals) on "mouse cortical neurons" (mouse brain cells). They found that one group of chemicals, which they referred to as "cluster 2", "mimics brain disorders" such as autism, advanced age, Alzheimer's, Parkinson's disease, and other neurodegenerative disorders. The chemicals (all pesticides, and mainly fungicides) causing these effects are: fenamidone, pyraclostrobin, famoxadone, trifloxystrobin, fenpyroximate, azoxystrobin, fluoxastrobin pyridaben and rotenone. Even though this study was done on mouse cortical neurons (in vitro), it is meaningful because of the similarities with human brain cells.

Very little is known about human exposure to these chemicals (how much is our exposure?) and their effects on humans, but the data suggest effects similar to that in neurological disorders. The researchers point out that many of the chemical residues in this cluster were found on conventionally raised foods, especially leafy green vegetables, and were detected at relatively high levels, especially pyraclostrobin. Most of these fungicides only came into use after 2000 and usage of these fungicides has been increasing in the U.S, with the exception of pyridaben (decreasing use) and rotenone (very low use). "These data suggest significant human exposure potential to many of the chemicals in cluster 2".

They point out that these fungicide residues have not been detected on organically produced foods (EPA and USDA data), which suggests a way to minimize exposure. None of these chemicals can be used by organic farmers in the U.S. Possible exposure is also from gardens and lawns (if used), contaminated water, and for farm workers in conventional agriculture. From Science Daily:

Could new class of fungicides play a role in autism, neurodegenerative diseases?

Scientists at the UNC School of Medicine have found a class of commonly used fungicides that produce gene expression changes similar to those in people with autism and neurodegenerative conditions, including Alzheimer's disease and Huntington's disease.

Mark Zylka, PhD, senior author of the study and associate professor of cell biology and physiology at UNC, and his team exposed mouse neurons to approximately 300 different chemicals.... "Based on RNA sequencing, we describe six groups of chemicals," Zylka said. "We found that chemicals within each group altered expression in a common manner. One of these groups of chemicals altered the levels of many of the same genes that are altered in the brains of people with autism or Alzheimer's disease." Chemicals in this group included the pesticides rotenone, pyridaben, and fenpyroximate, and a new class of fungicides that includes pyraclostrobin, trifloxystrobin, fenamidone, and famoxadone. Azoxystrobin, fluoxastrobin, and kresoxim-methyl are also in this fungicide class.

"We cannot say that these chemicals cause these conditions in people," Zylka cautioned. "Many additional studies will be needed to determine if any of these chemicals represent real risks to the human brain." Zylka, a member of the UNC Neuroscience Center, and his group found that these chemicals reduced the expression of genes involved in synaptic transmission -- the connections important for communication between neurons. If these genes are not expressed properly, then our brains cannot function normally. Also, these chemicals caused an elevated expression of genes associated with inflammation in the nervous system. This so-called neuroinflammation is commonly seen in autism and neurodegenerative conditions.

The researchers also found that these chemicals stimulated the production of free radicals -- particles that can damage the basic building blocks of cells and that have been implicated in a number of brain diseases. The chemicals also disrupted neuron microtubules. "Disrupting microtubules affects the function of synapses in mature neurons and can impair the movement of cells as the brain develops," Zylka said. "We know that deficits in neuron migration can lead to neurodevelopmental abnormalities. We have not yet evaluated whether these chemicals impair brain development in animal models or people."

Jeannie T. Lee, MD, PhD, professor of genetics at Harvard Medical School and Massachusetts General Hospital, who was not involved in this research, said, "This is a very important study that should serve as a wake-up call to regulatory agencies and the general medical community. The work is timely and has wide-ranging implications not only for diseases like autism, Parkinson's, and cancer, but also for the health of future generations. I suspect that a number of these chemicals will turn out to have effects on transgenerational inheritance."

Zylka's group also analyzed information from the U.S. Geological Survey, which monitors countywide pesticide usage, as well as the Food and Drug Administration and the U.S. Department of Agriculture, which test foodstuffs yearly for pesticide residues. Of the chemicals Zylka's team studied, only the usage of pyridaben has decreased since 2000. Rotenone use has remained the same since 2000. However, the use of all the fungicides in this group has increased dramatically over the past decade.

Indeed, a study from the Environmental Protection Agency found that pyraclostrobin is found on foods at levels that could potentially affect human biology, and another study linked pyraclostrobin usage to honeybee colony collapse disorder. The pesticide rotenone was previously implicated in Parkinson's disease through replicated animal experiments and through human epidemiological studies.....Previous work has also shown that a single dose of the fungicide trifloxystrobin reduced motor activity for several hours in female rats and for days in male rats. Disrupted motor function is a common symptom of Parkinson's disease and other neurological disorders. The related fungicide picoxystrobin impaired motor activity in rats at the lowest dose tested.

Zylka added, "The real tough question is: if you eat fruits, vegetables or cereals that contain these chemicals, do they get into your blood stream and at what concentration? That information doesn't exist." Also, given their presence on a variety of foodstuffs, might long term exposure to these chemicals -- even at low doses -- have a cumulative effect on the brain?

Zylka noted that conventionally grown leafy green vegetables such as lettuce, spinach, and kale have the highest levels of these fungicides. But due to each chemical's effectiveness at reducing fungal blights and rust, crop yields have increased and farmers are expanding their use of these chemicals to include many additional types of food crops.

Zylka's team hopes their research will encourage other scientists and regulatory agencies to take a closer look at these fungicides and follow up with epidemiological studies. "Virtually nothing is known about how these chemicals impact the developing or adult brain," Zylka said. "Yet these chemicals are being used at increasing levels on many of the foods we eat."

Applying fungicide to apple orchard. Credit: Univ. of Kentucky Agriculture Extension

Published on Leave a comment on Taking Antidepressants During Pregnancy and Autism

A large study found that using antidepressants during the second or third trimester of pregnancy increases the risk that the child will have autism by 87%,  especially if the mother takes selective serotonin reuptake inhibitors (SSRIs). A drawback was that the study looked at associations rather than actual cause (which would have meant randomly assigning women to either treatment or no treatment - which is unethical). From Medical Xpress:

Taking antidepressants during pregnancy increases risk of autism by 87 percent

Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children's hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies.

"The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role," she explained. "Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs." Her findings were published today in JAMA Pediatrics.

Bérard and her colleagues worked with data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. In addition to information about the mother's use of antidepressants and the child's eventual diagnosis of autism, the data included a wealth of details that enabled the team to tease out the specific impact of the antidepressant drugs. 

"We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant's critical brain development occurs during this time," Prof. Bérard said. "Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger's syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." 

The findings are hugely important as six to ten percent of pregnant women are currently being treated for depression with antidepressants. In the current study, 1,054 children were diagnosed with autism (0.72% of the children in the study), on average at 4.5 years of age. Moreover, the prevalence of autism amongst children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today. While that increase can be attributed to both better detection and widening criteria for diagnosis, researchers believe that environmental factors are also playing a part.

"It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis - the creation of links between brain cells," Prof. Bérard explained. "Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero".

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Two studies finding various forms of air pollution having effects on the developing fetus - the first one (fine particulate air pollution) to autism, and the second (outgassing of new flooring) to later breathing problems.

From Medical Xpress: Fine particulate air pollution linked with increased autism risk

Women exposed to high levels of fine particulate matter specifically during pregnancy—particularly during the third trimester—may face up to twice the risk of having a child with autism than mothers living in areas with low particulate matter, according to a new study from Harvard School of Public Health (HSPH). The greater the exposure, the greater the risk, researchers found. It was the first U.S.-wide study exploring the link between airborne particulate matter and autism.

"Our data add additional important support to the hypothesis that maternal exposure to air pollution contributes to the risk of autism spectrum disorders," said Marc Weisskopf, associate professor of environmental and occupational epidemiology and senior author of the study.... Prior studies have suggested that, in addition to genetics, exposure to airborne environmental contaminants, particularly during pregnancy and early life, may affect risk of autism. This study focused specifically on the pregnancy period.

The study population included offspring of participants living in all 50 states in Nurses' Health Study II, a cohort of more than 116,000 female U.S. nurses begun in 1989. The researchers collected data on where participants lived during their pregnancies as well as data from the U.S. Environmental Protection Agency and other sources on levels of fine particulate matter air pollution (PM2.5)—particles 2.5 microns in diameter or smaller—in locations across the U.S. The researchers identified 245 children who were diagnosed with autism spectrum disorder (ASD) and a control group of 1,522 children without ASD during the time period studied.

Exposure to PM2.5 was significantly associated with autism during pregnancy, but not before or after, the study found. And during the pregnancy, the third trimester specifically was significantly associated with an increased risk. Little association was found between air pollution from larger-sized particles (PM10-2.5) and autism.

From Science Daily: New floor covering can lead to breathing problems in babies

New flooring in the living environment of pregnant women significantly increases the risk of infants to suffer from respiratory diseases in their first year of life. This is the result of a study that demonstrates that exposure to volatile organic compounds in the months before and after birth induces breathing problems in early childhood. The scientists therefore recommend that redecoration should be avoided during pregnancy or in the first year of children’s life.

The observed health risks are caused by increased concentrations of volatile organic compounds (in short: VOCs), such as styrene or ethylbenzene, which escape from new flooring and are then absorbed through the respiratory air. "We therefore do not recommend that laminate, carpet or floor coverings be laid in the homes of pregnant women. Although the concentrations of these volatile chemicals are lower if no adhesive is used when installing the flooring, even then the concentrations are still high enough to significantly increase the risk of infants suffering from respiratory complaints in their first few months," explains Dr. Ulrich Franck from the UFZ. 

Earlier studies from Leipzig had already shown that chemicals from home renovations lead to changes in the immune system of new-born children.... According to our results, exposure to these volatile chemical compounds seems to be more critical in pregnancy than in the first year of a child's life," concludes Dr. Irina Lehmann from the UFZ, who is in charge of the LINA study on lifestyle and environmental factors and their influence on the risk of allergies in newborn babies. An analysis of the data showed that renovations after the birth of a child had a much lower impact on respiratory problems than during pregnancy.

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Another reason to be concerned about air pollution. And another study showing a link with environmental chemicals (this time coarse and fine particulate matter, known as PM10, which arises in part from traffic-related air pollution) and autism. From Science Daily:

Researcher adds to evidence linking autism to air pollutants

A researcher at the University of Wisconsin-Milwaukee (UWM) has added to a growing body of evidence that links autism to air pollutants such as those generated by cars and trucks.

Amy Kalkbrenner's study, published this week online at the journal Epidemiology, showed that pollution's impact on autism rates in North Carolina is similar to results of pollution-autism studies in California -- despite weather and climate differences between the two states. In addition, the work of Kalkbrenner and her colleagues, building on previous studies, showed that women in the third trimester of pregnancy were more susceptible to the damaging effects of air pollution on their unborn child.

"It adds another piece supporting the hypothesis that environmental chemicals are part of the autism puzzle," says Kalkbrenner, an assistant professor in UWM's Joseph J. Zilber School of Public Health. Autism, a spectrum of disorders affecting interpersonal relations and work achievement, now affects some 1 in 68 children in the U.S.

Her research team focused on exposure to coarse and fine particulate matter, known as PM10, which arises in part from traffic-related air pollution...Researchers used a new, more exact tool to measure the levels of particulate matter in smaller slices of time, based on pollution at the family's address during pregnancy. With this method, they were able to compare exposures during specific weeks of pregnancy. The approximately one thousand children who later developed some form of autism spectrum disorders were then compared to all other children.

Reasons for increased susceptibility in the third trimester of pregnancy are not known at this time. However, Kalkbrenner says this finding is consistent with theories that show links between autism and altered brain network development, specifically synaptic connections that are developing during the final months of pregnancy.

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This is really an important finding. For a while now many scientists have thought there was an environmental exposure (such as pesticides) link to autism. From Science Daily:

Autism, intellectual disability incidence linked with environmental factors

An analysis of 100 million US medical records reveals that autism and intellectual disability (ID) rates are correlated at the county level with incidence of genital malformations in newborn males, an indicator of possible congenital exposure to harmful environmental factors such as pesticides.

Autism rates -- after adjustment for gender, ethnic, socioeconomic and geopolitical factors -- jump by 283 percent for every one percent increase in frequency of malformations in a county. Intellectual disability rates increase 94 percent. Slight increases in autism and ID rates are also seen in wealthier and more urban counties.

The study, published by scientists from the University of Chicago March 13 in PLOS Computational Biology, confirms the dramatic effect of diagnostic standards. Incidence rates for Autism and ID on a per-person basis decrease by roughly 99 percent in states with stronger regulations on diagnosis of these disorders.

"Autism appears to be strongly correlated with rate of congenital malformations of the genitals in males across the country," said study author Andrey Rzhetsky, PhD, professor of genetic medicine and human genetics at the University of Chicago. "This gives an indicator of environmental load and the effect is surprisingly strong."

Although autism and intellectual disability have genetic components, environmental causes are thought to play a role. To identify potential environmental links, Rzhetsky and his team analyzed an insurance claims dataset that covered nearly one third of the US population. They used congenital malformations of the reproductive system in males as an indicator of parental exposure to toxins.

Male fetuses are particularly sensitive to toxins such as environmental lead, sex hormone analogs, medications and other synthetic molecules. Parental exposure to these toxins is thought explain a large portion of congenital reproductive malformations, such as micropenis, hypospadias (urethra on underside of the penis), undescended testicles and others.

The researchers created a statistical baseline frequency of autism and ID across the country. They then looked at the actual rates of these disorders, county-by-county. Deviations from the baseline are interpreted as resulting from local causes. Factors such as age, ethnicity, socioeconomic groups and geopolitical statuses were analyzed and corrected for.

The team found that every one percent increase in malformations in a county was associated with a 283 percent increase in autism and 94 percent increase in ID in that same county. Almost all areas with higher rates of autism also had higher rates of ID, which the researchers believe corroborates the presence of environmental factors. In addition, they found that male children with autism are almost six times more likely to have congenital genital malformations. Female incidence was linked with increased malformation rates, but weakly so. A county-by-county map of autism and ID incidence above or below the predicted baseline for the entire US is included in the study.

Non-reproductive congenital malformations and viral infections in males were also associated with double digit increases in autism and ID rates. Additionally, income appeared to have a weak effect -- every additional $1,000 of income above county average was correlated with around a three percent increase in autism and ID rates. An increased percentage of urban population in a county also showed a weak increase in rates.

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From NPR:

More Hints That Dad's Age At Conception Helps Shape A Child's Brain

Traditionally, research has focused on women's "biological clock." But in recent years, scientists have been looking more and more at how the father's age at conception might affect the baby, too. A study published Wednesday hints that age really might matter — in terms of the child's mental health.

Researchers from the University of Indiana and the Karolinska Institute found that compared with children fathered by men who were 20-24 years old, kids born to dads who were 45 or older were three times as likely to have autism and 13 times as likely to have ADHD. Kids born to older dads were also more likely to go on to develop substance abuse problems and get lower grades in school. The findings appear in JAMA Psychiatry.

To figure out how paternal age was related to children's psychiatric health, the researchers looked at millions of parents in Sweden who had children between 1973 and 2001. The researchers took into account the mother's age, as well as other demographic factors that might play a role in the child's cognitive development and mental health.

"There's a growing body of literature that suggests that advancing paternal age is associated with a host of problems," D'Onofrio tells Shots. Another study, published in JAMA Psychiatrylast month, found that the children of older fathers seemed to be at greater risk for developing schizophrenia and autism.

D'Onofrio and his colleagues paid special attention to siblings and cousins, and found that even among kids in the same extended family, a dad's age when his child was born made a difference.

The results are in line with a growing body of research linking older fatherhood with various developmental problems in children.

However, the study looks only at how paternal age and children's mental health are associated — it's a correlation, Reichenberg cautions, not a proven causal link. Scientists haven't yet determined the mechanisms of the effect. But it doesn't seem to be simply a matter of overdiagnosis among the children of older parents, the scientists say. Other research has found that as men get older, their sperm cells are more likely to contain random mutations that might, theoretically, contribute to disorders like autism in their kids.

Ultimately, men and women of all ages, he says, should remember that age is only one of many factors influencing the developing baby's health.

"The most important thing is [that] future mothers and fathers should still go ahead and have children, even if the father is older than 45 or 50," Reichenberg says. "Most of these children will be absolutely fine."